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This qualitative case study uses a life-course approach to explore syndemic vulnerability in a former fishing village in the Netherlands. Building on four years of fieldwork in a low-income neighborhood, we explored salient themes between and across families and generations. Elderly community members (>65 years) were interviewed to map village history and explore how contextual factors have affected family life, health, and wellbeing since the 1940s. We systematically traced and compared processes leading to or from syndemic vulnerability by studying seven families across three generations. Adults with at least one of clustering diseases, their parents (when possible), and their children participated in semi-structured life-course interviews. A complex interaction of endemic social conditions, sociocultural normative processes, learned health behaviors, and disheartening life events shaped families' predispositions for a syndemic of psychological distress, cardiometabolic conditions, and musculoskeletal pain. Educational attainment, continued social support, and aspirational capabilities emerged as themes related to decreasing syndemic vulnerability. This study demonstrates that syndemic vulnerability is potentially intergenerational and reveals the need for culturally sensitive and family-focused syndemic interventions. Future longitudinal research should focus on unravelling the pathogenesis of the clustering of psychological distress, cardiometabolic conditions, and musculoskeletal pain among young people.
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http://dx.doi.org/10.1016/j.socscimed.2020.113122 | DOI Listing |
In Silico Pharmacol
September 2025
Bioinformatics Facility Center, University of North Bengal, Raja Rammohanpur, Siliguri, West Bengal 734013 India.
COVID-19 persists globally with profound social and economic consequences, and its complex interplay with other diseases makes it a syndemic. Rheumatoid arthritis (RA), a chronic autoimmune disorder, has shown increased incidence during the pandemic, with patients displaying higher susceptibility to COVID-19. This overlap prompted the hypothesis of ''.
View Article and Find Full Text PDFInt J Environ Res Public Health
August 2025
Implementation Research Division, Aurum Institute, Johannesburg 2193, South Africa.
Tuberculosis (TB) remains a critical public health issue in Johannesburg, South Africa, driven by a complex interplay of individual, social, and structural factors. This study assessed the syndemic relationship between these determinants to understand their collective impact on TB burden and treatment outcomes. A cross-sectional survey was conducted among TB patients attending selected clinics, examining behavioural risks (e.
View Article and Find Full Text PDFAIDS Behav
August 2025
Department of Community Health Sciences, Boston University, Boston, MA, USA.
While digital health interventions (DHIs) have become an increasingly common approach to address HIV vulnerability among young sexual and gender minority men who have sex with men (YSGMMSM), few studies consider the role of neighborhood disadvantage in DHI efficacy and engagement. The present study is a secondary data analysis of 212 YSGMMSM aged 16-24 that combined biological and clinical survey data from the primary efficacy randomized controlled trial (RCT) of P3, a PrEP adherence DHI, with a measure of neighborhood disadvantage to characterize P3 engagement and efficacy among high and low disadvantage neighborhoods. We found that participants residing in high disadvantage neighborhoods engaged with P3 a median of 63 days (IQR = 39-76), compared to 77 days (IQR = 51-82) in low disadvantage neighborhoods.
View Article and Find Full Text PDFArch Sex Behav
August 2025
Eli Coleman Institute for Sexual and Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School Minneapolis, Minneapolis, MN, USA.
Women who sell sex in street-based settings (WSS) experience overlapping social and structural vulnerabilities, including housing instability, stigma, violence, and interactions with the criminal legal system, which shape their health and risk environments. Overlapping vulnerabilities to factors such as violence and substance use can drive health inequities. We used a syndemics framework to help understand how WSS perceive and manage these overlapping vulnerabilities.
View Article and Find Full Text PDFAIDS Behav
August 2025
School of International Service, American University, Washington, D.C., USA.
Sexual and gender minority people (SGM) in Nigeria experience disproportionate HIV burden, with an HIV prevalence four to ten times higher than the national average. Better understanding the factors that create HIV vulnerability in this population is important for designing effective interventions, particularly in a context largely hostile to SGM. We assessed a conceptual model describing a syndemic of discrimination, material insecurity, depression, substance use, intimate partner violence, and police and other violence among SGM in Abuja, Nigeria.
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